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About:
Multivariate Analysis of Factors Affecting COVID-19 Case and Death Rate in U.S. Counties: The Significant Effects of Black Race and Temperature
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Academic Article
research paper
schema:ScholarlyArticle
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type
Academic Article
research paper
schema:ScholarlyArticle
isDefinedBy
Covid-on-the-Web dataset
has title
Multivariate Analysis of Factors Affecting COVID-19 Case and Death Rate in U.S. Counties: The Significant Effects of Black Race and Temperature
Creator
Ali, Muhammad
Ba,
Choudhri, Tanvir
Dreher, Nickolas
Durbin, John
Fares Marayati, Naoum
Gometz, Alex
Hannah, Theodore
Kostman, J
Li, Adam
Mcauley, Fiona
Spiera, Zachary
Source
MedRxiv
abstract
Objectives: Coronavirus disease-19 (COVID-19) has spread rapidly around the world, and many risk factors including patient demographics, social determinants of health, environmental variables, underlying health conditions, and adherence to social distancing have been hypothesized to affect case and death rates. However, little has been done to account for the potential confounding effects of these factors. Using a large multivariate analysis, this study illuminates modulators of COVID-19 incidence and mortality in U.S. counties while controlling for risk factors across multiple domains. Methods: Data on COVID-19 and various risk factors in all U.S. counties was collected from publicly available data sources through April 14, 2020. Counties with at least 50 COVID-19 cases were included in case analyses and those with at least 10 deaths were included in mortality models. The 661 counties meeting inclusion criteria for number of cases were grouped into quartiles and comparisons of risk factors were made using t-tests between the highest and lowest quartiles. Similar comparisons for 217 counties were made for above average and below average deaths/100,000. Adjusted linear and logistic regression analyses were performed to evaluate the independent effects of factors that significantly impacted cases and deaths. Results: Univariate analyses demonstrated numerous significant differences between cohorts for both cases and deaths. Risk factors associated with increased cases and/or deaths per 100,000 included increased GDP per capita, decreased social distancing, increased age, increased percent Black, decreased percent Hispanic, decreased percent Asian, decreased health, increased poverty, increased diabetes, increased coronary heart disease, increased physical inactivity, increased alcohol consumption, increased tobacco use, and decreased access to primary care. Multivariate regression analyses demonstrated Black race is a risk factor for worse COVID-19 outcome independent of comorbidities, poverty, access to health care, and other mitigating factors. Lower daily temperatures was also an independent risk factor in case load but not deaths. Conclusions: U.S. counties with a higher proportion of Black residents are associated with increased COVID-19 cases and deaths. However, the various suggested mechanisms, such as socioeconomic and healthcare predispositions, did not appear to drive the effect of race in our model. Counties with higher average daily temperatures are also associated with decreased COVID-19 cases but not deaths. Several theories are posited to explain these findings, including prevalence of vitamin D deficiency. Additional studies are needed to further understand these effects.
has issue date
2020-04-22
(
xsd:dateTime
)
bibo:doi
10.1101/2020.04.17.20069708
has license
medrxiv
sha1sum (hex)
575314e1eaae3a145537f63a9e12d07a34782ae8
schema:url
https://doi.org/10.1101/2020.04.17.20069708
resource representing a document's title
Multivariate Analysis of Factors Affecting COVID-19 Case and Death Rate in U.S. Counties: The Significant Effects of Black Race and Temperature
resource representing a document's body
covid:575314e1eaae3a145537f63a9e12d07a34782ae8#body_text
is
schema:about
of
named entity 'death rates'
named entity 'Objectives'
named entity 'risk factors'
named entity 'LARGE'
named entity 'MORTALITY'
named entity 'OBJECTIVES'
named entity 'STUDY'
named entity 'COUNTIES'
named entity 'SPREAD'
named entity 'RAPIDLY'
named entity 'CONTROLLING'
named entity 'INCLUDING'
named entity 'ACROSS'
named entity 'HAVE'
named entity 'MODULATORS'
named entity 'study'
named entity 'health'
named entity 'potential'
named entity 'U.S. counties'
named entity 'However'
named entity 'COVID-19'
named entity 'social distancing'
named entity 'environmental variables'
named entity 'multivariate analysis'
named entity 'confounding effects'
named entity 'U.S.'
named entity 'Death Rate'
named entity 'Black Race'
named entity 'risk factors'
named entity 'flatten the curve'
named entity 'public health interventions'
named entity 'coronavirus disease 2019'
named entity '25(OH)D'
named entity 'COVID'
named entity 'social distancing'
named entity 'Wuhan'
named entity 'large Black'
named entity 'logistic regression'
named entity 'demographic'
named entity 'COVID'
named entity 'CC-BY-ND'
named entity 'United States'
named entity 'SARS-CoV-2 virus'
named entity 'COVID-19'
named entity 'D.C.'
named entity 'risk factors'
named entity 'SARS-CoV-2'
named entity 'New York City'
named entity 'social distancing'
named entity 'multivariate analyses'
named entity 'confounding'
named entity 'Spanish flu'
named entity 'Coronavirus'
named entity 'social distancing'
named entity 'air pollution'
named entity 'grocery store'
named entity 'National Health and Nutrition Examination Survey'
named entity 'Black Americans'
named entity 'poverty rate'
named entity 'U.S.'
named entity 'morbidity'
named entity 'confounding variables'
named entity 'GDP per capita'
named entity 'coronary heart disease'
named entity 'positively correlated'
named entity 'confounding variables'
named entity 'calcidiol'
named entity 'disease burden'
named entity 'food supply'
named entity 'multicollinearity'
named entity 'Flu vaccination'
named entity 'Asian American'
named entity 'Northern hemisphere'
named entity 'social distancing'
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